Heron Neil, Tully Mark A, McKinley Michelle C, Cupples Margaret E
Department of General Practice and Primary Care, Queen's University, Belfast, Northern Ireland.
BMC Fam Pract. 2014 Jan 15;15:11. doi: 10.1186/1471-2296-15-11.
Insufficient physical activity (PA) levels which increase the risk of chronic disease are reported by almost two-thirds of the population. More evidence is needed about how PA promotion can be effectively implemented in general practice (GP), particularly in socio-economically disadvantaged communities. One tool recommended for the assessment of PA in GP and supported by NICE (National Institute for Health and Care Excellence) is The General Practice Physical Activity Questionnaire (GPPAQ) but details of how it may be used and of its acceptability to practitioners and patients are limited. This study aims to examine aspects of GPPAQ administration in non-urgent patient contacts using different primary care electronic recording systems and to explore the views of health professionals regarding its use.
Four general practices, selected because of their location within socio-economically disadvantaged areas, were invited to administer GPPAQs to patients, aged 35-75 years, attending non-urgent consultations, over two-week periods. They used different methods of administration and different electronic medical record systems (EMIS, Premiere, Vision). Participants' (general practitioners (GPs), nurses and receptionists) views regarding GPPAQ use were explored via questionnaires and focus groups.
Of 2,154 eligible consultations, 192 (8.9%) completed GPPAQs; of these 83 (43%) were categorised as inactive. All practices were located within areas ranked as being in the tertile of greatest socio-economic deprivation in Northern Ireland. GPs/nurses in two practices invited completion of the GPPAQ, receptionists did so in two. One practice used an electronic template; three used paper copies of the questionnaires.End-of-study questionnaires, completed by 11 GPs, 3 nurses and 2 receptionists and two focus groups, with GPs (n = 8) and nurses (n = 4) indicated that practitioners considered the GPPAQ easy to use but not in every consultation. Its use extended consultation time, particularly for patients with complex problems who could potentially benefit from PA promotion.
GPs and nurses reported that the GPPAQ itself was an easy tool with which to assess PA levels in general practice and feasible to use in a range of electronic record systems but integration within routine practice is constrained by time and complex consultations. Further exploration of ways to facilitate PA promotion into practice is needed.
据报道，近三分之二的人口身体活动（PA）水平不足，这增加了患慢性病的风险。关于如何在全科医疗（GP）中有效实施身体活动促进措施，尤其是在社会经济条件不利的社区，还需要更多证据。一种被推荐用于全科医疗中身体活动评估且得到英国国家卫生与临床优化研究所（NICE）支持的工具是《全科医疗身体活动问卷》（GPPAQ），但其使用方法以及从业者和患者对其接受程度的细节有限。本研究旨在探讨在使用不同初级保健电子记录系统的非紧急患者就诊中GPPAQ的管理情况，并探究卫生专业人员对其使用的看法。
选取了四家因其位于社会经济条件不利地区而被选中的全科诊所，邀请其在两周时间内，向年龄在35 - 75岁、前来进行非紧急会诊的患者发放GPPAQ。他们采用了不同的发放方法和不同的电子病历系统（EMIS、Premiere、Vision）。通过问卷调查和焦点小组探讨了参与者（全科医生（GPs）、护士和接待员）对GPPAQ使用的看法。
在2154次符合条件的会诊中，192次（8.9%）完成了GPPAQ；其中83次（43%）被归类为身体活动不足。所有诊所均位于北爱尔兰社会经济剥夺程度最高的三分位区域内。两家诊所的全科医生/护士邀请患者完成GPPAQ，另外两家则由接待员进行邀请。一家诊所使用电子模板；三家使用问卷纸质副本。由11名全科医生、3名护士和2名接待员完成的研究结束时问卷以及两个分别由8名全科医生和4名护士参与的焦点小组表明，从业者认为GPPAQ易于使用，但并非在每次会诊中都适用。其使用延长了会诊时间，尤其是对于那些可能从身体活动促进中受益的复杂问题患者。
全科医生和护士报告称，GPPAQ本身是一种在全科医疗中评估身体活动水平的简便工具，并且在一系列电子记录系统中使用是可行的，但在常规实践中的整合受到时间和复杂会诊的限制。需要进一步探索促进身体活动促进措施融入实践的方法。
